Provider Demographics
NPI:1114003696
Name:HAGARTY & BISSELL, PLLC
Entity Type:Organization
Organization Name:HAGARTY & BISSELL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:TYLER
Authorized Official - Last Name:HAGARTY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:515-674-4466
Mailing Address - Street 1:PO BOX 155
Mailing Address - Street 2:
Mailing Address - City:COLFAX
Mailing Address - State:IA
Mailing Address - Zip Code:50054-0155
Mailing Address - Country:US
Mailing Address - Phone:515-674-4466
Mailing Address - Fax:515-674-3123
Practice Address - Street 1:475 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:COLFAX
Practice Address - State:IA
Practice Address - Zip Code:50054-9600
Practice Address - Country:US
Practice Address - Phone:515-674-4466
Practice Address - Fax:515-674-3123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty